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In this tutorial, the process of completing a HICFA 1500 claim form is explained for non-institutional health care providers submitting claims. The presenter typically files claims electronically but covers paper submissions for secondary claims with primary EOBs. The example uses a patient named Edna, beginning with Box 1, where "Other" is selected for her commercial insurance type. Box 2 is for the patient's name, Box 3 for date of birth and gender, Box 5 for the patient's address and phone number, and Box 6 indicates the patient’s relationship, which is "self" in this case. If there were a different policyholder, their information would be included. Finally, Box 8 is used for any other health benefit plans.
